Congruence between polysomnography obstructive sleep apnea and the pediatric sleep questionnaire: fatigue and health-related quality of life in juvenile idiopathic arthritis

Abstract

Purpose To examine the congruence between polysomnography obstructive apnea hypopnea index (OAHI) and parent reported obstructive sleep apnea (OSA) symptoms in 6-to-11 year-old children with juvenile idiopathic arthritis (JIA) and controls; and to compare fatigue and quality of life in JIA and control children based on OAHI and OSA symptoms. Methods Sixty-eight children with JIA and 75 controls and a parent participated. Children underwent one night of polysomnography in a sleep laboratory. Parents completed the sleep-related breathing disorders scale - Pediatric Sleep Questionnaire (PSQ), and both children and parents completed the Pediatric Quality of Life Generic Core Scale and the Multidimensional Fatigue scale. Results In JIA, 86% who met the OAHI clinical criteria for OSA (≥ 1.5) were above the PSQ OSA symptom cut-off score with a sensitivity of 0.86 and a specificity of 0.28. In the control group, 63% who met the OAHI clinical criteria for OSA, were above the PSQ OSA symptom cut-off score, with a sensitivity of 0.63 and a specificity of 0.42. All children above both the clinical criteria for OAHI and OSA symptom cut-off score had the most impaired quality of life and greater fatigue compared to those below both the clinical criteria for OAHI and the OSA symptom cut-off score. Conclusion Children who meet clinical criteria for OSA and also scored high on a parent reported screening tool for OSA symptoms had the most impaired quality of life and more fatigue. The PSQ has potential to identify children at risk for OSA.

Restricted upper airway dimensions in patients with dentofacial deformity from juvenile idiopathic arthritis

“…Arens et al found that the upper airway cross sectional area varies along the centerline between children with OSA and healthy controls with significant airway narrowing occurring continuously throughout most of the length of the upper airways in the OSA group. Arens et al speculated that the continuous narrowing of the upper airways may be essential to the air flow resistance that characterizes subjects with OSA [ 33 ].…”

“…OSA is at the extreme end of the manifestation of SDB and has received attention in JIA research [ 32 , 33 ]. OSA is characterized by increased upper airway resistance causing partial (hypopnea) or complete collapse (apnea) of the upper airways followed by increased respiratory efforts, arousals, and sleep fragmentation [ 47 ].…”

Sleep Health Assessment and Treatment in Children and Adolescents with Chronic Pain: State of the Art and Future Directions

“…PSG is usually conducted in a specialized hospital sleep laboratory and is typically limited to a single overnight assessment. There are some limited data on PSG to assess sleep in youth with [ 27 ] chronic pain, mostly in small samples with rheumatological conditions [ 28 , 29 ], and it is not yet clear how PSG may help with the evaluation or management of sleep complaints in youth with chronic pain.…”

Pediatric quality of life multidimensional fatigue scale (PedsQL-MFS) detects the effects of a 3-week Inpatient body weight reduction program for children and adolescents with obesity

“…Fatigue is associated with significant distress and psychological disability and is a frequent reason for adolescents presenting to primary medical services [13,43]. Fatigue is frequently among the most distressing symptoms associated with a range of paediatric medical conditions [26] including cancer [46], primary immunodeficiencies [50], paediatric-onset multiple sclerosis [57], lupus [18], and juvenile idiopathic arthritis [66] contributing to poorer healthrelated quality of life [19]. Tasks that produce fatigue have been demonstrated to increase pain in people with fibromyalgia [15].…”